Individual provider Active NPI

Maritza B Gomez, MD, MED

  • Pediatrics Physician
  • Plano, TX
National Provider Identifier
1689253213
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
V3005 Issued in TX
Practice address
7601 Preston Rd
Plano, TX 75024-3214
Phone
(214) 456-9250
Fax
(214) 456-1240
NPI assigned
Apr 2, 2021
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 195387 CA
Pediatrics Physician 208000000X V3005 TX Primary

Addresses

Primary practice location

7601 Preston Rd
Plano, TX 75024-3214

Mailing address

7601 Preston Rd
Plano, TX 75024-3214

Other practice location 1

550 16th St
San Francisco, CA 94143-2549
Phone (415) 502-2362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240930000354 TX Practitioner - Pediatric Medicine 8820529043 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Education

State licenses

LicenseStateTypeSpecialty
195387CAMDPediatrics Physician
V3005TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc Pediatrics CurrentSince Sep 11, 2024 Accepting new patients
Dallas Physician Medical Services for Children Inc Pediatrics CurrentSince Sep 11, 2024 Accepting new patients
Complex Care Medical Services Corporation Pediatrics Past Accepting new patients
Children's Health System of Texas Past Accepting new patients

Locations

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

1935 Medical District Dr
#908
Dallas, TX 75235

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1689253213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 PRESTON RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 PRESTON RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243214",
            "telephone_number": "214-456-9250",
            "fax_number": "214-456-1240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 16th St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432549",
            "country_code": "US",
            "telephone_number": "415-502-2362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MARITZA",
        "middle_name": "B",
        "credential": "MD, MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "195387",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "V3005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.